An Investigation of Tooth/Implant-Supported Fixed Prosthesis Designs with Two Different Stress Analysis Methods: An in vitro Study

Purpose: Tooth/implant‐supported fixed prostheses (TIFPs) present biomechanical design problems, because the implant is rigidly anchored within the alveolus, and the tooth is attached by the periodontal ligament that allows movement. While TIFP designs with rigid connectors (RCs) are preferred by many clinicians, the designs containing non‐rigid connectors (NRCs) are suggested as a method to compensate for these mobility differences. However, studies have failed to show the advantage of one design over the other. This study examined stresses formed around the implant and natural tooth abutments under occlusal forces, using two dimensional finite element (2D‐FEM) and photoelastic stress analysis methods (PSAM). Materials and Methods: Connection of TIFP designs were investigated in distal extension situations using stress analysis interpreted with the 2D‐FEM and PSAM. Three TIFP (screw type implant, 3.75 mm × 13 mm) models with various connection designs (i.e., rigidly connected to an abutment tooth, connected to an abutment tooth with an NRC, connected to an abutment implant with an NRC) were studied. The stress values of the three models loaded with vertical forces (250 N) were analyzed. Results: The highest level of stresses around the implant abutment was noted on the TIFPs with the RC. On the other hand, NRCs incorporated into prostheses at the site of the implant abutment reduced the level of stresses in bone. Conclusion: It could be suggested that if tooth and implant abutments are to be used together as fixed prostheses supports, NRCs should be placed on the implant abutment‐supported site.